I have my Apple ID set up since the late 1990’s when I lived in the US and it functions on a regional basis. I now live in Italy and there are apps I cannot download. Can I set up two apple ids with two different regions?
Your Apple ID is tied to your physical address and payment method. So, if you're no longer living in the U.S., you're no longer eligible for a U.S. Apple ID. You should change your region to Italy.
Change your Apple ID country or region - Apple Support
You can do that but you will not find it easy to use both of them, particularly on a mobile device, and particularly if you do something such as subscribe to Apple Music -->
From: View and remove your devices that are associated with Apple ID purchases - Apple Support
"When you try to associate a device that was previously associated, you might notice a message that says, "This device is associated with another Apple ID. You cannot associate this device with another Apple ID for [number] days." You might need to wait up to 90 days to associate the device with a different Apple ID."
Regional content and Apple id
